National plan needed to prepare for expected surge in dementia cases: report

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TORONTO - Canada needs a national strategy to prepare for a tidal wave of dementia cases in the coming decades that could swamp the health-care system and put a severe drain on the economy, a new report says.
The report by the Alzheimer Society, entitled "Rising Tide: The Impact of Dementia on Canadian Society," suggests that cases of the mind-robbing disease will more than double to 1.25 million within 30 years as baby boomers move into old age.
"The impact of the growth of the population of people with dementia is going to have huge economic consequences," said society spokesman David Harvey, noting that projections suggest direct and indirect costs of the disease will multiply ten-fold.
"Today, someone in Canada develops dementia every five minutes; in 30 years, there will be one new case every two minutes," Harvey said. "If nothing changes, this sharp increase in the number of people living with dementia will mean that by 2038, the total costs associated with dementia will reach $153 billion a year."
The report, prepared over two years at a cost of $150,000, also projects that annual new cases of Alzheimer's and other forms of dementia will more than double to 257,800 in 2038 from the current 103,700 a year.
The document suggests a number of possible steps to help reduce the impact of dementia in the future, including:
- Prevention programs based on healthy diet and physical activity that can delay the onset of dementia by two years, with a potential cost saving of $219 billion over the 30-year period.
- Enhanced skill-building and support programs for family caregivers, many of whom also suffer financial hardship because they must leave jobs to look after a loved one with dementia.
- Assigning a system navigator, or case manager, to each newly diagnosed dementia patient and their caregivers, which could help the person remain in their own home longer and lessen the strain on the long-term care system.
Harvey said increased funding is critical for research into the causes of dementia and more effective treatments. The society wants to see annual funding tripled to $72 million from the current $24 million.
The report also predicts that the overall amount of unpaid care delivered by family members will more than triple by 2038, to 756 million hours from the current 231 million hours.
"There will be a huge impact on the number of people that will be involved in caregiving," said Harvey. "And caregiving in its own right, because of the nature of the disease, it's a very difficult task for a person to perform."
"And the consequences of the stress levels related to caregiving can often have a detrimental effect on the caregiver themselves."
Gerry Matier of Vancouver learned how quickly life can change when his wife Diane Jamieson was diagnosed with a form of dementia that progressively destroyed her ability to communicate and to care for herself.
Just 47 when symptoms began in late 1998, the former registered nurse had developed frontal temporal dementia.
"I really was caught totally by surprise when the doctor told me what it was," said Matier. "It was like being run over by a truck."
Matier, executive director of the Insurance Council of British Columbia, became his wife's primary caregiver. He said he was able to take on the role because of supportive staff and an employer that allowed him to do much of his work from home.
But in 2006, the deterioration of Jamieson's condition forced him to put his wife into long-term care - a step he had never planned to take.
"It just got to a peak in early 2006 when I was having trouble managing, even with a (hired) caregiver," he said from Vancouver.
"I think I made a mistake like most caregivers. You think, `Oh yeah, I can manage this, I can do all these things, I don't need any help.' And while I was certainly getting help, I probably should have had a lot more and sooner."
Carrie McAiney, a dementia expert at McMaster University, said there are a number of projects being assessed that would improve access to information for people newly diagnosed with dementia and to support services for family members caring for them.
"Usually people don't try to access services until the caregiver is burned out or until there's some type of crisis," she said from Hamilton.
There is also a need for more doctors, nurses, therapists and other health professionals well-versed in caring for people with dementia - and that need will grow exponentially as cases surge in the coming years.
"The amount of education around aging generally, and dementia specifically, in many training programs is just not adequate."
McAiney said the federal government needs to step up and implement a national framework for dealing with dementia, as many other countries have done.
"The scope of the problem is huge, so you can't just focus on one particular area," she said. "You need to enhance research, you need education, you need to enhance public awareness, reducing stigma. You need to enhance services, including within the community."
"I think we really need to open our eyes and look at what it is we're doing now and how we can make improvements. Because it's coming," she said of the expected tsunami of Alzheimer's and other dementia diagnoses.
"And we're not dealing with things as they are right now. So with more and more cases, it's just going to get worse."

Organizations: Alzheimer Society, Canadian Society, Insurance Council of British Columbia Jamieson's McMaster University

Geographic location: Canada, TORONTO, Vancouver Hamilton

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